In recent years hospitals and medical care facilities in general have committed tremendous resources to upgrading information technology systems. There is, of course, an underlying problem that encourages this automation. Medical errors and the inability to consistently and accurately count for and track costs are serious problems facing the medical community as a whole. While there is a clear need to continue to improve information management in hospitals and healthcare facilities, it is not so clear how best to accomplish such. There are many challenges that face hospitals and medical care facilities when it comes to designing and implementing effective and efficient information technology systems. After all, information technology systems designed for hospitals and medical care facilities must be designed around physicians, nurses and other medical staff that are almost always in constant motion. Care must be given to providing information technology systems that do not disrupt the process of care provided by these institutions.
Generally, information technology systems presently utilized in hospitals and medical care facilities rely substantially on fixed centralized stations. However, this approach does not adequately address the problems of medical errors and delays in processing and managing clinical information. In the end, centralized fixed stations alone do not lend themselves to convenience and efficiency. A computer in every hospital room, for example, is probably not the best solution. Such an approach is very expensive and does not lend itself to the natural process of healthcare that takes place in a hospital or medical care facility. Placing information technology systems, including handheld computing devices, in the hands of the medical staff can result in increased productivity, a decrease in errors, and a reduced documentation workload for nurses that are already in short supply.
Another serious problem for hospitals and medical care facilities is cost accounting, and particularly tracking costs, managing and controlling inventory, and billing all costs to the appropriate patient. Hospitals and healthcare facilities typically maintain large inventories that must be managed and controlled. Huge numbers of items are transferred in and transferred out central supply and operating rooms on a daily basis. Those in charge of inventory control must take steps to discern what supplies are being used, the timeframe that they are being used, who they are being used for, and how often the supplies or items are called for. An efficient and accurate inventory management and control system will account for all items used.
For the most part, inventory management control systems utilized in healthcare facilities are less sophisticated than one finds in other industries. Items are often ordered as needed or when certain items become critically low.
In some cases, when an item is used during an operation, a nurse or attendant will fetch the item from a central inventory room and may make an appropriate paper entry. In many cases there is minimum accountability as to the items that have been removed from the central supply. In general, for the most part, in hospitals and other healthcare facilities, the methods and procedures for maintaining and controlling inventory is replete with errors and omissions.
The task of accurately tracking costs in an operating room, for example, is a difficult undertaking especially when viewed in the context that when surgeries are performed, that the care and well being of the patient comes first and all other matters, including cost accounting, are secondary. During the course of a surgery various items and supplies are used for the patient's benefits and all of these should be accounted for. For example, basic sterile supplies, sometimes referred to as sterile bundles that include sterile gowns, gloves, bowls, etc., will be used. Further, trays of instruments and disposable components associated with these instruments will be used. In addition, during the course of a surgery, various instrumentation will be utilized and some of the instrumentation will include disposable components. Further, there are other disposable items such as staples, staplers, etc. In many cases implants are utilized. This is simply a sample of the types of items and objects that are either spent or used during the course of a surgery. In practice, many hospitals utilize hand accounting to track these items of cost and to record them to the patient's account. As a result, the documentation of items used during surgical procedures is often incomplete or not available. Typically there are no graphical images of any instruments or items utilized in a surgery which could provide proof of use in cases where billing records are questioned. Importantly, many items are used, but go unaccounted for. These losses that are experienced by virtually every hospital that operates operating rooms are huge and continue to play an important part in the seemingly uncontrollable escalation of healthcare costs.